The Minnesota Department of Human Services was fined $63,000 — the largest such penalty against a state agency in more than a decade — for failing to protect workers at the St. Peter psychiatric hospital from violent assaults by patients.

The citation by Minnesota OSHA identified nine incidents between early May and mid-July that exposed employees to risk of serious injury or death, underscoring the challenges the state faces in maintaining order in a treatment facility that houses more than 200 of the state's most violent and mentally ill patients.

The citation was issued within a week after another violent assault at the hospital. According to employees, a male patient attacked a female security counselor, tearing at her clothes, before co-workers intervened. The St. Peter Police Department is still investigating the incident.

The reports raise fresh questions about the adequacy of recent efforts to control violence at the Minnesota Security Hospital, the state's largest psychiatric hospital.

Since late last year, the hospital has installed new security cameras; intensified staff training on how to de-escalate violent situations; acquired new protective equipment, such as forearm pads, for staff; hired more security counselors; and opened a new admissions unit this spring to protect new patients from more violent ones.

"More work needs to be done to improve safety at the Minnesota Security Hospital," said Carol Olson, executive director of forensic treatment services at DHS. "We are committed to that work and are currently collaborating with staff, labor partners and others to ensure a safer environment for all employees and patients."

State officials and hospital employees say efforts to curb violence have been hampered by a new state law that has forced the security hospital to accept more patients with criminal histories, who may be more prone to violence. In 2013, the Legislature passed a law, known as the "48-hour rule," that requires state psychiatric hospitals to admit county jail inmates within 48 hours after they are committed by a judge for mental illness.

Staff members at the security hospital have suffered 111 work-related injuries through October, compared with 101 during all of 2014 and 83 in 2013, state records show.

In July, OSHA launched an investigation following a report that a 16-year-old patient grabbed a security counselor by the hair, bashed her head against a wall and kicked her in the head repeatedly. The injured employee was taken to a Mayo Clinic facility in Mankato.

In May 2014, the security hospital was found responsible for the murder of a patient, Michael F. Douglas, who was found dead in his room after a fellow patient stomped on his head several times. A state investigation found that the hospital failed to adequately supervise its patients and that staff members were not adequately engaged. Investigators found it was likely that 1½ hours passed before the staff was aware that Douglas was lying on the floor, dying.

Timothy Headlee, a security counselor at the hospital and president of AFSCME Local 404, which represents about 800 workers there, said recent efforts to improve communication between management and staff should curb violence, but they are too new to fully take hold. Now, each time an assault occurs, management and workers hold a debriefing session to discuss ways it could have been prevented, he said.

"Violence is not under control, but we've still come a long way from where we were a year ago," Headlee said.

The recent OSHA report lists nine separate violations of state safety regulations in which employees "were not properly protected from workplace violence by an effective workplace violence prevention program." Each of the violations is described by OSHA as "serious," meaning death or serious physical harm has resulted or could be expected to result from the violation.

The state has 20 days to decide whether to contest the OSHA citation.

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